Abstract Body (Do not enter title and authors here): Introduction: The diversity of the healthcare workforce is essential for equitable and effective patient care. This comprehensive report analyzes the representation trends among cardiovascular fellows in the US over an 18-year period, focusing on gender, racial, and ethnic representation.

Methods: Utilizing data from the National Graduate Medical Education Census, this study analyzes trends in representation across gender, race, and ethnicity among cardiovascular medicine fellows. It examines the expansion of cardiology programs and fellow positions in specialties, assessing the evolution of diversity between 2005 and 2022 using J point trend analysis software.
Results: Growth Trends in Cardiology Specialties (2005-2022): Cardiology exhibited significant growth, with an AAPC of 2.6% for programs and 2.0-3.2% for fellow positions. IC showed an AAPC of 2.0% for programs and 2.8% for fellow positions. EP had a lower AAPC for programs (1.7%) but a higher rate for fellow positions (5.2%).
Gender Disparities: Women constituted 22% in CVM, 12.3% in EP, and 11% in IC. Despite these disparities, there was a promising increase in the representation of women over time, with a higher AAPC for women compared to men, indicating a shift towards greater gender diversity.
Racial and Ethnic Composition and Trends: White and Asian fellows accounted for over 70% of the total, while Black and Hispanic fellows made up less than 12%. The representation of White fellows decreased significantly, while Black fellows showed a significant increase in CVM. Hispanic fellows did not exhibit a significant increase and even showed a decrease in IC.
Medical School Backgrounds: USMDs comprised the majority of fellows, but DOs displayed the highest growth rate, particularly in EP (AAPC of 7.9%). IMGs had the highest AAPC in IC at 4%.

Conclusion: Our analysis revealed continued racial and gender disparities in the cardiology specialty. This report calls for concerted efforts from academic institutions, healthcare organizations, and policymakers to implement effective strategies for diversity and inclusion, reflecting the aim of creating a workforce that mirrors the diversity of the population it serves.